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Obstetrics and Gynaecology > Reproductive Physiology > Flashcards

Reproductive Physiology Flashcards

1
Q

Define Puberty.

A

developmental phase between childhood and adulthood whereby functional maturation of reproductive glands and external genitalia mediated by changes in sex hormones (GnRH, FSH, LH)

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2
Q

What are does adrenarche generally occur?

A

6-8 years old

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3
Q

What is Adrenarche?

A

Adrenal gland secretes androgens (DHEA)

Androgens cause growth spurt, pubic hair growth begins and breast development starts

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4
Q

What is Menarche?

A

Onset of menstrual cycle

  • Mature ova produced
  • Increase GnRH –> Increase FSH and LH
  • Ovaries responsive to FSH
  • Ovaries (theca cells) respond to LH by androgen and oestrogen production
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5
Q

What age does Menarche begin?

A

10-16 years old

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6
Q

State 3 examples of female phenotypic changes in Puberty

A

Pubic hair

Growth and maturation of reproductive tract: uterus and external genitalia

Fat deposition: breasts, buttocks, thighs

Closure of epiphyseal plates: Stop growing (end of puberty)

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7
Q

State 3 examples of male phenotypic changes in Puberty

A

Testicular enlargement

Pubic hair growth

Growth of larynx

Deepening of voice

Increased bone mass

Increased mass and strength of skeletal muscle

Thickened skin

Increased and thickened hair on trunk, arms, legs and face

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8
Q

What is the term for the index used to measure secondary sexual characteristics in M or F?

What are the broad categories?

A

Tanner Stages (sexual maturity ratings for assessment of secondary sexual characteristics)

F:

  • Pubic hair (Ph1-6)
  • Breast development (B1-5)

M:

  • Pubic hair (Ph1-6)
  • Genital development (G1-5)
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9
Q

What is the Female Monthly Sexual Cycle?

A

Ovarian Cycle + Menstrual Cycle

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10
Q

What are the two phases of the Ovarian cycle?

A

Follicular phase

Luteal phase

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11
Q

Which of the following does not occur in the follicular phase?

A. Days 1-14

B. Raised progesterone and oestrogen

C. Maturation of the egg

D. Ovulation signals its end

A

B. Raised progesterone and oestrogen

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12
Q

Which of the following does not occur in the follicular phase?

A. Days 1-14

B. Follicle produces oestrogen

C. Maturation of the egg

D. Ovulation signals its beginning

A

D. Ovulation signals its beginning

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13
Q

Which of the following is not true for the luteal phase?

A. Days 15-28

B. Development of corpus luteum

C. Corpus luteum produces Progesterone only

D. Induces preparation of reproductive tract for pregnancy

A

C. Corpus luteum produces Progesterone only

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14
Q

Which of the following is not true for the luteal phase?

A. Days 15-28

B. Development of corpus luteum

C. Corpus luteum produces Progesterone and Oestrogen

D. Induces preparation of reproductive tract for menstruation

A

D. Induces preparation of reproductive tract for menstruation

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15
Q

In the follicular phase, which of the following is true?

A. GnRH decreases prior to FSH and LH rise

B. Rising FSH and LH stimulates oestrogen

C. Oestrogen levels inhibit both FSH and LH

D. Inhibin inhibits H release only

A

B. Rising FSH and LH stimulates oestrogen

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16
Q

Outline the follicular phase of the hormonal control of the female monthly sexual cycle.

A

GnRH rise from Hypothalamus

FSH + LH rise at beginning of cycle from Anterior Pituitary gland

Rising FSH + LH stimulates oestrogen production

Oestrogen inhibits FSH but not tonic LH

Inhibin also inhibits FSH

Moderate oestrogen stimulated positive feedback ≈ more oestrogen

Note: Menstrual phase (4 days) causes endometrium disintegration

Note: Proliferative phase (6-14 days) allows thickening of endometrium due to oestrogen levels

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17
Q

Outline the luteal phase of the hormonal control of the female monthly sexual cycle.

A

High oestrogen ≈ elevated LH (positive feedback) ≈ LH burger ≈ ovulation

Ruptured follicle becomes corpus luteum

Corpus luteum produces Progesterone and oestrogen to inhibit LH and FSH production

10 days.. corpus luteum degenerate and progesterone and oestrogen levels significantly drop with FSH and LH no longer repressed

FSH and LH increased as new cycle begins

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18
Q

What is the major phase regarding menstrual effects which occurs during the Luteal hormonal phase?

A

Secretory (Progestational) phase

Progesterone stimulates maintenance and development of endometrium for correct environment should ovum fertilisation occur

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19
Q

State 2 functions of the corpus luteum

A

Oestrogen production = endometrium thickening

Progesterone production = endometrium development and maintenance

Inhibition of LH and FSH

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20
Q

What is the menopause?

A

Last menstrual period due to reduced oestrogen and oocyte supply diminished with 12 months of cessation of periods occurring after 45 years, mean age 51

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21
Q

Give 3 symptoms of the menopause

A 
Amenorrhea (> 12 months)
Hot flushes 
Low mood
Night sweats 
Hirsutism 
Reduced libido 
Vaginal atrophy 
Vaginal dryness
Irregular menses
Dry skin and dry hair
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22
Q

Give a suggested reason for the aetiology of Menopause.

A
  • Oocyte depletion (low quality)
  • Insensitive to LH and FSH
  • Age-related CNS changes cause reduced GnRH secretion
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23
Q

State 3 potential complications of the menopause.

A
  • CVD
  • CVI
  • OP
  • Breast Ca risk reduced
  • Hirsutism
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24
Q

What is the andropause?

A

symptoms/decline in general health associated with decrease in testosterone in older men (> 50 years old)

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25
Q

Give a suggested aetiological cause of the andropause.

A
  • Gonadal LH insensitivity
  • Androgen production reduced
  • Serum LH and FSH increased
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26
Q

State 5 functions of the female reproductive system.

A
  • Ova production
  • Receive sperm
  • Capacitation
  • Transport sperm and ova to site of fertilisation
  • Gestation
  • Parturition
  • Nourishment of infant by lactation
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27
Q

What is the primary function of the Ovaries with regards to reproductive functions?

A. Site of fertilisation

B. Receptacle for sperm and birth canal

C. Allow sperm through to uterus

D. Maturation and release of ova

A

D. Maturation and release of ova

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28
Q

What is the primary function of the Uterus with regards to reproductive functions?

A. Site of fertilisation

B. Receptacle for sperm and birth canal

C. Allow sperm through to uterus

D. Maintain foetus during gestation and expel in postpartum

A

D. Maintain foetus during gestation and expel in postpartum

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29
Q

What is the primary function of the Oviducts with regards to reproductive functions?

A. Site of fertilisation

B. Receptacle for sperm and birth canal

C. Allow sperm through to uterus

D. Maintain foetus during gestation and expel in postpartum

A

A. Site of fertilisation

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30
Q

What is the primary function of the Vagina with regards to reproductive functions?

A. Site of fertilisation

B. Receptacle for sperm and birth canal

C. Allow sperm through to uterus

D. Maintain foetus during gestation and expel in postpartum

A

B. Receptacle for sperm and birth canal

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31
Q

What is the primary function of the Vaginal opening with regards to reproductive functions?

A. Allow penis in/baby out

B. Receptacle for sperm and birth canal

C. Allow sperm through to uterus

D. Maintain foetus during gestation and expel in postpartum

A

A. Allow penis in/baby out

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32
Q

What is the primary function of the Cervix with regards to reproductive functions?

A. Allow penis in/baby out

B. Receptacle for sperm and birth canal

C. Allow sperm through to uterus

D. Maintain foetus during gestation and expel in postpartum

A

C. Allow sperm through to uterus

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33
Q

What is oogenesis?

A

form of gametogenesis in which mitotic and meiotic divisions occur to produce an ovum (female gamete)

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34
Q

Outline the process of Oogenesis.

A

Primordial germ cells arrest in meiosis I = primary oocytes

Primary oocytes arranged in gonads in clusters around follicular cells –> primordial follicles

Stages:

Pre-Antral:
1º oocyte grows

Follicular cells grow and proliferate to form stratified cuboidal epithelium (= granulosa cells)

Granulosa cells secrete glycoproteins to form zona pellucida around 1º oocyte

CT differentiates to become theca folliculi, responsive to LH –> secrete androgens

Antral:
Fluid-filled spaces form between granuloa cells ≈ secondary follicles which become dominant under influence of FSH, LH and oestrogen

Pre-ovulatory stage:
LH burger induces pre-ovulatory stage
Meiosis II occurs with first polar body creating two and secondary oocyte arrests in metaphase of meiosis II, 3 hours prior to ovulation

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35
Q

Which is the primary reproductive function of the penis?

A. Produce sperm

B. Suspend testes

C. Secrete semen to suspend and sustain sperm

D. transfer sperm to female

A

D. transfer sperm to female

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36
Q

Which is the primary reproductive function of the scrotum?

A. Produce sperm

B. Suspend testes

C. Secrete semen to suspend and sustain sperm

D. transfer sperm to female

A

B. Suspend testes

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37
Q

Which is the primary reproductive function of the accessory glands?

A. Produce sperm

B. Suspend testes

C. Secrete semen to suspend and sustain sperm

D. transfer sperm to female

A

C. Secrete semen to suspend and sustain sperm

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38
Q

Which is the primary reproductive function of the testes?

A. Produce sperm

B. Suspend testes

C. Secrete semen to suspend and sustain sperm

D. transfer sperm to female

A

A. Produce sperm

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39
Q

Outline the route by which sperm exits the scrotum

A

SEVEN UP

Seminiferous tubules

Epididymis

Vas Deferens

Ejaculatory duct

NOTHING

Urethra

Penis

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40
Q

State the 4 stages of Sexual Arousal.

A
  1. Excitement: sexual awareness
  2. Plateau: Excitement intensification
  3. Orgasm: Intense physical pleasure
  4. Resolution: Post-orgasm refractory period
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41
Q

Which of the following is not a part of the plateau phase of Sexual Arousal?

A. Tenting effect

B. Enlarge upper 1/2 vagina

C. Excitement intensification

D. Testicular vasocongestion + erection

A

D. Testicular vasocongestion + erection

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42
Q

Which of the following is not a part of the plateau phase of Sexual Arousal?

A. Tenting effect

B. Enlarge upper 1/2 vagina

C. Excitement intensification

D. Return of body to pre-excitement state

A

D. Return of body to pre-excitement state

43
Q

Which of the following is not a part of the excitement phase of Sexual Arousal?

A. Vaginal lubrication

B. Vasodilation of vagina

C. Testicular vasocongestion

D. Tenting effect of vagina

A

D. Tenting effect of vagina

44
Q

Which of the following is not a part of the Resolution phase of Sexual Arousal?

A. Relaxation

B. Return to pre-excitement states

C. Testicular vasocongestion

D. Temporal refractory period

A

C. Testicular vasocongestion

45
Q

Outline the mechanism of the erection reflex.

A
  1. Psychogenic/Somatogenic stimulation

1) PSNS stimulation
- Secretion via glands
- Erection

2) Sympathetic stimulation
- Inhibition to penile arterioles
- Penile arteriolar dilation

46
Q

Outline the mechanism of ejaculation.

A
  1. Stimulation of mechanoreceptors in glans of penis
  2. Sympathetic response
    - Contraction of prostate
    - Contraction of reproductive ducts
    - Contraction of seminal vesicles
    - Skeletal muscle contraction –> Semen into urethra
47
Q

List the components of Semen

A

Prostatic fluid + Seminal Fluid + Sperm

48
Q

Outline the stages of IVF

A

1) Pre-fertilisation:
- Oocyte removed (6-24 hours viable)
- Spermatozoa removed (24-48 hours viable)
- Capacitation (remove glycoprotein coat + whip-like tail movements + acrosomal reaction)

2) Fertilisation
- Allurin released by ovum = attract sperm
- Bind (fertilin) to 2º oocyte + acrosomal reaction allows tip to burrow into zona pellucida

49
Q

What chemoattractant molecule is released by the ovum to attract sperm?

A

Allurin

50
Q

What protein does sperm use to bind to the 2º oocyte.

A

Fertilin

51
Q

State the primary function of the sperm tail in fertilisation

A
  • Locomotion

- Blocking other sperms to prevent polyspermy

52
Q

What are the types of block to polyspermy?

A

1) 1º Block: Egg membrane depolarises ≠ sperm fusion 



2) 2º Block: Changes to zona pellucida (cortical reaction) making sperm binding difficult 


53
Q

Following fertilisation, what occurs to the 2º oocyte?

A

secondary oocyte continues from metaphase of meiosis II to finish meiosis and 2nd polar body formed and extruded from egg, ensuring female pronucleus is haploid 


54
Q

Outline the conceptus journey.

A

Fertilisation –> Cleavage –> Morula (16 cell mulberry) –> Blastocyst

55
Q

Where does the blastocyst implant?

A

Uterine epithelium with trophoblast cells growing into the endometrium, releasing nutrients for the embryo

56
Q

What day does the blastocyst become buried in the uterine lining by?

A

Day 12

57
Q

Outline the process of placental formation and development.

A

Formation:
1. Trophoblast proteases digest and allow trophoblast to embed into uterine endometrium

  1. Trophoblast induces decidualisation of endometrium (vascularisation + nutrient storage)
  2. Trophoblast buried into uterine lining by day 12

Development:
1. Trophoblast differentiates into multinucleate syncitiotrophoblasts invading and breaking down capillaries to form cavities with maternal blood

  1. Embryo sends capillaries into syncitiotrophoblast projections = placental vili

Note: Each villus contains foetal capillaries separated from maternal blood by thin layer of tissue thus no direct contact

  1. Exchange of substances via functionalists; 5th week of pregnancy
58
Q

Which of the following hormones are released from the blastocyst in the detection of pregnancy?

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

C. ßhCG

59
Q

This is the function of which of the following hormones?

‘Prolongs corpus luteum of pregnancy to produce oestrogen and progesterone’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

C. ßhCG

60
Q

This is the function of which of the following hormones?

‘Stimulates growth of myometrium’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

A. Oestrogen

61
Q

This is the function of which of the following hormones?

‘Stimulates development of mammary gland ducts’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

A. Oestrogen

62
Q

This is the function of which of the following hormones?

‘Stimulates development of mammary gland ducts’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

A. Oestrogen

63
Q

This is the function of which of the following hormones?

‘Suppress uterine contractions’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

B. Progesterone

64
Q

This is the function of which of the following hormones?

‘Promote formation of mucous plug’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

B. Progesterone

65
Q

This is the function of which of the following hormones?

‘Stimulate development of mammary milk glands for lactation’

A. Oestrogen

B. Progesterone

C. Prolactin

D. PTHrp

A

C. Prolactin

66
Q

This is the function of which of the following hormones?

‘Reduce maternal glucose utilisation, increasing plasma FA, increase glucose and FA available for foetus’

A. Oestrogen

B. Progesterone

C. hCS

D. PTHrp

A

C. hCS

67
Q

This is the function of which of the following hormones?

‘Mobilise Maternal calcium if calcium deficient’

A. Oestrogen

B. Progesterone

C. hCS

D. PTHrp

A

D. PTHrp

68
Q

This is the function of which of the following hormones?

‘Soften cervix and loosen pelvic connective tissue’

A. Oestrogen

B. Relaxin

C. hCS

D. PTHrp

A

B. Relaxin

69
Q

This is the function of which of the following hormones?

‘Stimulate DHEAS production by foetal adrenal cortex’

A. placental CRH

B. Relaxin

C. hCS

D. PTHrp

A

A. placental CRH

70
Q

At what stage does the placenta take over from the Corpus Luteum in production of Oestrogen and Progesterone?

A

10 weeks

71
Q

How soon after postpartum does menstruation begin providing there are no interventions?

A

4-6 weeks

72
Q

State the 4 stages of Sexual Arousal.

A
  1. Excitement: sexual awareness
  2. Plateau: Excitement intensification
  3. Orgasm: Intense physical pleasure
  4. Resolution: Post-orgasm refractory period
73
Q

Which of the following is not a part of the plateau phase of Sexual Arousal?

A. Tenting effect

B. Enlarge upper 1/2 vagina

C. Excitement intensification

D. Testicular vasocongestion + erection

A

D. Testicular vasocongestion + erection

74
Q

Which of the following is not a part of the plateau phase of Sexual Arousal?

A. Tenting effect

B. Enlarge upper 1/2 vagina

C. Excitement intensification

D. Return of body to pre-excitement state

A

D. Return of body to pre-excitement state

75
Q

Which of the following is not a part of the excitement phase of Sexual Arousal?

A. Vaginal lubrication

B. Vasodilation of vagina

C. Testicular vasocongestion

D. Tenting effect of vagina

A

D. Tenting effect of vagina

76
Q

Which of the following is not a part of the Resolution phase of Sexual Arousal?

A. Relaxation

B. Return to pre-excitement states

C. Testicular vasocongestion

D. Temporal refractory period

A

C. Testicular vasocongestion

77
Q

Outline the mechanism of the erection reflex.

A
  1. Psychogenic/Somatogenic stimulation

1) PSNS stimulation
- Secretion via glands
- Erection

2) Sympathetic stimulation
- Inhibition to penile arterioles
- Penile arteriolar dilation

78
Q

Outline the mechanism of ejaculation.

A
  1. Stimulation of mechanoreceptors in glans of penis
  2. Sympathetic response
    - Contraction of prostate
    - Contraction of reproductive ducts
    - Contraction of seminal vesicles
    - Skeletal muscle contraction –> Semen into urethra
79
Q

List the components of Semen

A

Prostatic fluid + Seminal Fluid + Sperm

80
Q

Outline the stages of IVF

A

1) Pre-fertilisation:
- Oocyte removed (6-24 hours viable)
- Spermatozoa removed (24-48 hours viable)
- Capacitation (remove glycoprotein coat + whip-like tail movements + acrosomal reaction)

2) Fertilisation
- Allurin released by ovum = attract sperm
- Bind (fertilin) to 2º oocyte + acrosomal reaction allows tip to burrow into zona pellucida

81
Q

What chemoattractant molecule is released by the ovum to attract sperm?

A

Allurin

82
Q

What protein does sperm use to bind to the 2º oocyte.

A

Fertilin

83
Q

State the primary function of the sperm tail in fertilisation

A
  • Locomotion

- Blocking other sperms to prevent polyspermy

84
Q

What are the types of block to polyspermy?

A

1) 1º Block: Egg membrane depolarises ≠ sperm fusion 



2) 2º Block: Changes to zona pellucida (cortical reaction) making sperm binding difficult 


85
Q

Following fertilisation, what occurs to the 2º oocyte?

A

secondary oocyte continues from metaphase of meiosis II to finish meiosis and 2nd polar body formed and extruded from egg, ensuring female pronucleus is haploid 


86
Q

Outline the conceptus journey.

A

Fertilisation –> Cleavage –> Morula (16 cell mulberry) –> Blastocyst

87
Q

Where does the blastocyst implant?

A

Uterine epithelium with trophoblast cells growing into the endometrium, releasing nutrients for the embryo

88
Q

What day does the blastocyst become buried in the uterine lining by?

A

Day 12

89
Q

Outline the process of placental formation and development.

A

Formation:
1. Trophoblast proteases digest and allow trophoblast to embed into uterine endometrium

  1. Trophoblast induces decidualisation of endometrium (vascularisation + nutrient storage)
  2. Trophoblast buried into uterine lining by day 12

Development:
1. Trophoblast differentiates into multinucleate syncitiotrophoblasts invading and breaking down capillaries to form cavities with maternal blood

  1. Embryo sends capillaries into syncitiotrophoblast projections = placental vili

Note: Each villus contains foetal capillaries separated from maternal blood by thin layer of tissue thus no direct contact

  1. Exchange of substances via functionalists; 5th week of pregnancy
90
Q

Which of the following hormones are released from the blastocyst in the detection of pregnancy?

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

C. ßhCG

91
Q

This is the function of which of the following hormones?

‘Prolongs corpus luteum of pregnancy to produce oestrogen and progesterone’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

C. ßhCG

92
Q

This is the function of which of the following hormones?

‘Stimulates growth of myometrium’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

A. Oestrogen

93
Q

This is the function of which of the following hormones?

‘Stimulates development of mammary gland ducts’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

A. Oestrogen

94
Q

This is the function of which of the following hormones?

‘Stimulates development of mammary gland ducts’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

A. Oestrogen

95
Q

This is the function of which of the following hormones?

‘Suppress uterine contractions’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

B. Progesterone

96
Q

This is the function of which of the following hormones?

‘Promote formation of mucous plug’

A. Oestrogen

B. Progesterone

C. ßhCG

D. PTHrp

A

B. Progesterone

97
Q

This is the function of which of the following hormones?

‘Stimulate development of mammary milk glands for lactation’

A. Oestrogen

B. Progesterone

C. Prolactin

D. PTHrp

A

C. Prolactin

98
Q

This is the function of which of the following hormones?

‘Reduce maternal glucose utilisation, increasing plasma FA, increase glucose and FA available for foetus’

A. Oestrogen

B. Progesterone

C. hCS

D. PTHrp

A

C. hCS

99
Q

This is the function of which of the following hormones?

‘Mobilise Maternal calcium if calcium deficient’

A. Oestrogen

B. Progesterone

C. hCS

D. PTHrp

A

D. PTHrp

100
Q

This is the function of which of the following hormones?

‘Soften cervix and loosen pelvic connective tissue’

A. Oestrogen

B. Relaxin

C. hCS

D. PTHrp

A

B. Relaxin

101
Q

This is the function of which of the following hormones?

‘Stimulate DHEAS production by foetal adrenal cortex’

A. placental CRH

B. Relaxin

C. hCS

D. PTHrp

A

A. placental CRH

102
Q

At what stage does the placenta take over from the Corpus Luteum in production of Oestrogen and Progesterone?

A

10 weeks

103
Q

How soon after postpartum does menstruation begin providing there are no interventions?

A

4-6 weeks

Obstetrics and Gynaecology (8 decks)

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